A federal judge ruled in favor of the Federal Trade Commission (FTC) in an appeal, after an initial ruling in favor of the hospital systems. Referencing the antitrust law, or competition law, the FTC stated that the merger would have potentially bestowed majority control of roughly 55% of the entire city's general acute care inpatient services to the new system, resulting in lower-quality and higher-cost patient care.

NorthShore and Advocate Health said in separate statements that they do not plan to appeal the decision.